FOR TUES Older kids can teach younger peers to be healthy

NEW YORK (Reuters Health) - Elementary school children who
took part in a healthy living program with older peers reduced
their waist sizes and showed improvements in self-esteem,
according to a new Canadian study.

In the so-called Healthy Buddies program, students learn
about healthy foods, physical activity and positive body image
from older kids, rather than adult teachers or coaches.

Researchers say the program could potentially reduce rates
of childhood obesity.

McGavock, from the University of Manitoba in Winnipeg,
co-authored the study that was a collaboration between his
university and policymakers in the province of Manitoba.

"About one in three children are overweight or obese and in
some communities it's up to one in two, so 50 percent of our
youth," he said.

McGavock said previous school-based interventions or
afterschool programs hadn't worked to reduce obesity.

"A new model had come out where a group at the University of
British Columbia (also in Canada) had developed a peer mentoring
program that relied on older peers delivering the healthy living
messages to younger peers and it looked like it had worked,"
McGavock said.

He said early studies of the Healthy Buddies program looked
promising, but Manitoba policymakers wanted stronger evidence
and to see whether they could disseminate it widely across the
province.

In the fall of 2009, the researchers enrolled 647 students
from 19 elementary schools in Manitoba in their study. Students
from 10 schools were randomly selected to receive the Healthy
Buddies curriculum and nine were put on a waiting list and
served as a control group.

About half of the students attended rural schools and 36
percent were overweight or obese.

At the start of the study, the researchers measured kids'
waists, calculated their body mass index - a measure of weight
relative to height - and assessed the children's physical
activity and fitness levels, self-esteem, knowledge of healthy
living and eating habits.

Teachers from each of the schools were trained in the
program so they could deliver weekly lessons to students nine to
12 years old. Then, the students presented the same lessons to
younger "buddies" who were six to eight years old.

At the end of the school year, 584 students had completed
the program, and the researchers reevaluated them. They found
the younger kids in the program had lost about three quarters of
an inch from their waists, on average.

"That's important because that's a major risk factor for
type 2 diabetes and other chronic diseases," McGavock said.

Older kids' waists also shrunk, but the effect was smaller,
and potentially due to chance. On the other hand, the benefit
was larger for overweight and obese kids, according to the
findings published in JAMA Pediatrics.

There was no change in waist size among kids in the
comparison group.

The researchers found that kids who participated in the
Healthy Buddies program also showed positive changes in their
self-esteem.

"The program was particularly effective in overweight youth
and in our First Nations or indigenous youth, and they're the
ones who we're the most worried about," McGavock said.

"So overall if we had to send a message to parents and
policymakers, it is that this works in the kids we want it to
work in, it builds their confidence, and as a result, it
potentially could lower the rates of childhood obesity," he
said.

The program did not lead to changes in body mass index,
exercise or fitness, however.

McGavock said Healthy Buddies is sustainable and fairly
low-cost because it doesn't rely on expensive teacher time -
kids deliver it to kids - and it can be built into the
curriculum.

"It's really difficult to make changes in the school
environment where there are so many moving parts and competing
interests," Dr. Stephen Pont told Reuters Health.

"This study shows that it is possible to engage schools and
then to demonstrate improved health in kids," said Pont, who
wasn't involved in the new research. He works at Dell Children's
Medical Center of Central Texas in Austin and is chair of the
American Academy of Pediatrics Provisional Section on Obesity.

Pont said that engaging older students as mentors and
leaders is a good approach.

"When kids teach other kids how to be healthier they are
more likely to continue to practice healthier lifestyles
themselves," he said.

More schools are realizing that healthier students do better
academically and also miss less class, he added.

"As more studies are published showing the positive link
between better health and academic success, more schools will
realize that through embracing initiatives to improve the health
of their students they will also improve their academic
outcomes," Pont said.